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  • Comparison of Endoscopic Transphenoidal and Transcranial Approches to the Tuberculum Sellae Meningiomas

    Final Number:

    Savas Ceylan; Ihsan Anik MD; burak CABUK

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Removal of tuberculum sella meningiomas is traditionally performed through transcranial approaches. Wide use of the endoscope in transphenoidal pituitary surgery is recently accessible through the tuberculum sellae with an endoscope-assisted or purely endoscopic technique. Extended endoscopic approach is an important and alternative route for meningiomas, which are located on the midline originating from the tuberculum sellae and particularly extended to optic canals

    Methods: We compared the indications and the limitations of inferior (extended endoscopic endonasal transphenoidal) and superior (transcranial) approaches for tuberculum sellae meningiomas depending on the volume, location, optic nerve and vascular invasion, preoperative MRI findings of the tumor, reoperation rates and complications such as CSF fistula. Fifty-one (51) patients with Tuberculum Sellae meningioma were operated on, between (July) 2000 and (March) 2015 at Neurosurgical Department, Kocaeli University, Kocaeli, Turkey. 39 patients were female and 12 patients were male. Age ranged between 28-71. We have performed 56 operations on 51 patients consisting of; 30 endoscopic transphenoidal approaches on 28 patients, 26 transcranial approaches on 23 patients. In 3 patients, endoscopic approaches were abandoned and transcranial approaches were performed

    Results: Total removal was achieved on 23 of 28 patients (82,14 %) for inferior approaches and 19 of 23 patients (82.60%) for the superior approaches. In these series, there were 5 reoperations. The 2 of which were for CSF fistula after inferior approaches, and rest 3 were transcranial approaches for the recurrence after the superior approaches.

    Conclusions: We have discussed the limitations and complications of the inferior and superior approaches for tuberculum sellae meningiomas on the basis of our results

    Patient Care: In tthe selection of best approach for the patients with tuberculum sellae meningioma

    Learning Objectives: Comparison oflimitations and complications of the inferior and superior approaches for tuberculum sellae meningiomas


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